What should be administered to a hypoglycemic patient found intoxicated with a full bottle of insulin nearby?

In the case of a hypoglycemic patient who has been found intoxicated with a full bottle of insulin nearby, administering dextrose (specifically 50% dextrose, or D50W) is the most appropriate response. This is because the patient is likely experiencing a severe drop in blood sugar levels due to the excess insulin in their system.

Dextrose provides immediate glucose to the bloodstream, which helps rapidly alleviate the hypoglycemic state. It’s a concentrated form of glucose that quickly elevates blood sugar levels, making it effective in treating hypoglycemia, especially when the patient is unable to take oral medications due to their intoxication or impaired consciousness.

While glucagon can also be used in cases of hypoglycemia, its effectiveness is generally better in non-intoxicated individuals or when intravenous access for dextrose is not available. Insulin would worsen the hypoglycemic state, making it a contraindicated option. Oral glucose tablets may not be viable for an intoxicated or unconscious patient, as they require swallowing ability, which may not be present. Therefore, D50W is the best choice for rapidly correcting the low blood sugar caused by the overdose of insulin.